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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018710
Report Date: 05/08/2023
Date Signed: 05/08/2023 03:09:32 PM

Document Has Been Signed on 05/08/2023 03:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MOYA FAMILY CHILD CAREFACILITY NUMBER:
198018710
ADMINISTRATOR:MOYA, ROXANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 388-4617
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Licensee Roxana MoyaTIME COMPLETED:
03:30 PM
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On 05/08/2023 Licensing Program Analyst (LPA) Andrew Alemoh, met with licensee, Roxana Moya, and helper/assistant #1 who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA observed 6 children in care and 2 adults caring for them. Family members residing in the home include 5 adults (licensee, licensee's husband and licensee two daughters.) Facility hours of operation are Monday - Saturday for 23 hours. Per licensee there is no Incidental Medical Services (IMS) policy.

Physical Plant: Main care is provided in the converted garage/day care room. The children use the bathroom located in the day care room. There are cubbies for children to place their belongings. LPA observed age appropriate toys and play equipment in the plastic storage containers located in the day care room. Infants sleep in cribs in the living room area of the home, and the older children sleep in the day care room. The off-limits areas are all four bedrooms, one restroom, the office and the backyard. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the laundry room and the off-limits backyard area. No medications on the premises, but licensee keeps her vitamins locked in the kitchen cabinet. Hazardous items (sharp knives are kept in the kitchen in the upper cabinet high enough that they are inaccessible to children).

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOYA FAMILY CHILD CARE
FACILITY NUMBER: 198018710
VISIT DATE: 05/08/2023
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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguishers (2A10BC,3A40BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on April 2023. The fireplace is located in the living room, and was observed to be barricaded by a small black iron fence and made inaccessible to children. Facility roster maintained current. Children's sleep logs were observed.

Bathroom: The bathroom in the day room was clean and operable. There is a changing table in the day care bathroom. LPA observed extra diapers and cleaning whips underneath the changing table. LPA observed dry snacks in the top cabinet of the day care bathroom making them inaccessible to children. First aid kit was stored in the day care bathroom in the top cabinet. There is a children's toilet located in the bathroom. There is a second bathroom located in the home. Per licensee older children use the bathroom in the home. LPA observed the "older children's bathroom" to be clean and operable. No prohibited items were observed in the older children's bathroom.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOYA FAMILY CHILD CARE
FACILITY NUMBER: 198018710
VISIT DATE: 05/08/2023
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Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the laundry room(locked during business hours) and the off-limits backyard. Breakfast, lunch, snacks and dinner are provided. Licensee stated she currently does have a food program. Naps are provided on cots the day care room

Outdoor: The backyard is off-limits. The front yard is on limits. The front yard is completely fenced in with a brick wall and iron fence in the front of the home. There is a sink in the front yard for children to wash their hands. There are gates on each side of the home that make the backyard access not available to day care children. LPA observed play structures secured and safe for children to play on. The play structures are on top of turf grass making the impact soft for children. There are two dogs in the premises that are located in the backyard. Per licensee, dogs do not come in contact when children are present. LPA observed age appropriate toys, well secured and safe for children.

There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 07/23. Mandated Reporter expires on 12/09/23. LPA reminded licensee; mandated reporter training must be completed every 2 years.

Documents Provided and or Discussed: Postings, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MOYA FAMILY CHILD CARE
FACILITY NUMBER: 198018710
VISIT DATE: 05/08/2023
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Licensee Roxana was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Roxana and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023
LIC809 (FAS) - (06/04)
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